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SPACE-AGE TECHNOLOGY PROMISES TO CUT HEALTH CARE RED TAPE

 SPACE-AGE TECHNOLOGY PROMISES TO CUT HEALTH CARE RED TAPE
 CLEVELAND, July 21 /PRNewswire/ -- An electronic revolution is coming to health care, and Blue Cross & Blue Shield of Ohio (BCBSO) is in the front lines.
 While just 5 percent to 10 percent of all medical claims paid by major commercial insurance carriers are received electronically, according to the Wall Street Journal, BCBSO is well past the halfway mark. The company already processes about 75 percent of hospital claims, 50 percent of doctor claims and nearly all drug claims electronically.
 Many people, including President Bush, predict electronic claims processing and billing will be a substantial shot in the arm for the ailing health care industry. They point to projected financial savings, greater accuracy and faster turnaround in payment of health care claims.
 Paperwork -- the scourge of the industry -- is on the run, and sooner or later the system will be nearly paperless and fully computerized. A bill currently in Congress would establish one uniform claims processing format for all to follow. The national Blue Cross Blue Shield Association is helping a federal effort to devise a universal format.
 With BCBSO, it's a lot sooner than later. BCBSO, the oldest and largest health insurer in Ohio, runs one of the three largest computer operations in the state at its Beachwood Data Center, 23700 Commerce Park Road, Beachwood.
 The Data Center administers approximately 600 billion bytes (gigabytes) of readily accessible data, the equivalent of about 120 million typewritten pages -- or half a million books -- that can be called onto a computer screen in an average of 1.5 seconds. In addition, its archives contain the equivalent of nearly 2 billion typewritten pages of information. Collectively, the Data Center is capable of processing approximately 200 million instructions per second.
 BCBSO processes nearly 8 million doctor and hospital claims annually -- or 37,000 claims every day of the week. In addition, the company receives daily more than 7,200 phone inquiries plus another 21,000 written ones. It turns the average claim around in less than six days, and does so with nearly 98 percent accuracy.
 That kind of efficiency has propelled the company into the top ranks of Blue Cross Blue Shield plans in terms of performance. It also is one of the reasons why BCBSO's administrative expense ratio has been the lowest in Ohio over the past three years with about 90 cents of every premium dollar going to pay medical expenses.
 The electronic revolution has almost science fiction overtones. The Data Center's "war room," for example, reminds some people of the bridge of the Starship Enterprise with its convergence of data systems and powerful computer terminals.
 The system already uses optical disks, scanners and state-of-the-art "imaging" technology to process membership and underwriting data for selected segments of BCBSO business. By 1993, company officials expect to expand those capabilities to other segments and into claims processing and billing.
 Imaging -- which produces actual document pictures rather than raw data -- is expected to eliminate multiple steps in retrieval and processing, consolidate subscriber "files" in one place and further reduce cycle times significantly.
 Also just around the corner are Optical Character Recognition -- systems that can even read handwriting -- and "voice annotation," which involves digitized sound recordings of policyholder claim inquiries as part of their file.
 Eliminating paperwork alone will not solve the problem of runaway health care costs, but it will help. The Bush administration estimates that electronic processing of the four billion medical claims generated each year should save at least $8 billion annually.
 More than that, the Wall Street Journal noted that this electronic revolution means "insurers increasingly will compete on ability to gather medical as well as financial data and to use them to manage the health costs of their customers." And that means even more savings.
 -0- 7/21/92
 /CONTACT: David Eden of William Silverman & Co., 216-696-7750, for Blue Cross and Blue Shield of Ohio/ CO: Blue Cross and Blue Shield of Ohio ST: Ohio IN: INS HEA SU:


SM -- NYHFNS26 -- 1027 07/21/92 07:15 EDT
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Publication:PR Newswire
Date:Jul 21, 1992
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